Blue Cross Blue Shield Plan News Roundup: October 2023

The following Blue Cross Blue Shield announcements are just a few of the company activities from this month. AMI’s annual Blue Cross Blue Shield Plans Report provides profiles on each of the 34 BSBS plans as well as the BCBSA organization.


Bon Secours and Anthem Blue Cross and Blue Shield in Virginia have reached a multi-year agreement providing Anthem members with continued access to affordable, high-quality care at all Bon Secours hospitals, outpatient care centers, and physician offices. As a result, all Anthem Medicare Advantage and Medicaid health plan members will have continued in-network coverage at Bon Secours. Anthem has agreed to cover any claims that patients may have incurred during the period of time that Bon Secours was out of network with Anthem Medicare Advantage since August 1. The agreement also extends coverage for Anthem employer-based and Affordable Care Act plans. With the new contract, Anthem members covered by these plans will have access to affordable coverage at Bon Secours until 2028.


Arkansas Blue Medicare is offering a new benefit partnership and a variety of plan options for Medicare beneficiaries. Arkansas Blue Medicare has partnered with Walmart to offer members the Walmart Wellness Benefits Card. This new benefit offers HMO and PPO members $50-$150 each calendar quarter to spend on over-the-counter (OTC) health-related items. Beneficiaries can shop at Walmart and Walmart Neighborhood stores, online, via the Walmart app, by calling Walmart customer service, or via mail order.


Celgene and Bristol Myers Squibb (BMS) have used a pattern of unlawful patents to extend a monopoly in the market for Pomalyst (pomalidomide), a blockbuster drug used in the treatment of multiple myeloma, according to a lawsuit filed by Blue Cross and Blue Shield of Louisiana (BCBS). The class-action lawsuit filed in the U.S. District Court Southern District of New York alleges that BMS and Celgene extended the Pomalyst monopoly “(i) through a pattern of fraud on the U.S. patent office, (ii) by abuse of the federal judicial system, and (iii) by eventually sharing some of its illicitly acquired, supra-competitive profits with would-be generic competitors to have those generics further delay bona fide generic competition.”


Vermont’s largest private health insurer, Blue Cross Blue Shield of Vermont, has become a subsidiary of its much larger Michigan counterpart. The contract binding the nonprofit with Blue Cross Blue Shield of Michigan was signed and immediately went into effect. Blue Cross Blue Shield of Vermont provides health insurance to around 225,000 Vermonters, while Blue Cross Blue Shield of Michigan, also a nonprofit, insures roughly 5.2 million people in Michigan and other states.


Blue Cross Blue Shield of Michigan is adding Cancer Support through OncoHealth’s virtual platform, Iris, to its portfolio of cancer care solutions. Members with a cancer diagnosis, and their caregivers, will have immediate access to educational resources, clinical oncology expertise, mental health support and a network of peer mentors. The Cancer Support program complements and works in coordination with the treatment they’re receiving from their physicians.


Blue Care Network’s Price Edge, a service that automatically finds the lowest price available on medications when members fill their prescriptions, has reached $1 million in total member savings in just four months. The Price Edge program is one component of Blue Care Network’s ongoing efforts to help manage skyrocketing drug costs. Like coupon or travel apps that search and find the best deals, Price Edge scans and compares direct-to-consumer pricing with insurance pricing to give the best available price to members on select non-specialty, generic drugs. Price Edge works with both retail and mail order pharmacies and is being offered to Blue Care Network members automatically at no cost.


Blue Cross and Blue Shield of North Carolina (Blue Cross NC) agreed to acquire all North Carolina-based locations of FastMed. This would enable FastMed and Blue Cross NC, two North Carolina companies, to work together to fortify health care capacity in the state so North Carolinians have access to critical points of quality, affordable care. FastMed provides a wide range of care options, including preventive, telehealth, occupational health, primary, and urgent care. Blue Cross NC and FastMed would collaborate on and invest in ways to further enhance the patient experience at North Carolina FastMed locations.  


Highmark Health is joining forces with Spring Health to expand behavioral health access for a wide swath of its members. The two partners will launch a mental well-being platform that integrates into the insurers’ existing member app, providing convenient access to daily wellness activities, care navigation and clinical services both in-person and virtual, such as therapy, medication management and around-the-clock support.


BlueCross BlueShield of Tennessee and Radiology Alliance have finalized a new long-term agreement that supports affordable, high-quality care for BlueCross members. Under the new agreement, Radiology Alliance, which serves health care facilities and hospitals throughout Tennessee, is now in network for BlueCross coverage plans including Blue Networks P, S, L and E, as well as Medicare Advantage.